Questions about Medicaid? Here are answers

Utah has recently expanded its Medicaid program allowing for more Utahns than ever to enroll in the safety-net program. Medicaid is an important program that covers qualifying Utahns with health benefits, acting as the key to open the door for healthcare services.

There is free Medicaid enrollment assistance available—sign up for a free enrollment assistance appointment with Take Care Utah or call 2-1-1 to be connected to free help.

Below are common questions asked about Medicaid and information about where you can learn more.

Policies allowing young adults to stay on parent’s health insurance until 26, ACA Marketplace, and Medicaid expansion have reduced uninsured rates for young adults.

As a student, you’ve got a lot on your plate, like housing, picking your major, exams, and how COVID-19 impacts you. Having health coverage ensures that while you’re navigating all this, if you need Mental Health services or if injury or illness befalls you, you’ll have coverage in place to keep you secure.

Utah’s Medicaid covers any person who’s:

  • A Utah resident;
  • A US citizen or legal permanent resident;
  • Aged 19-64 (children qualify for Medicaid or CHIP based on their parent’s income); and
  • Meets income requirements (before taxes):
    Family size Monthly income Annual income
    1 $1,467 $17,609
    2 $1,983 $23,791
    3 $2,498 $36,156
    4 $3,013 $36,156

For families with more members, add $516/month or $6,182/annual for each additional person.

You can apply year-round. Medicaid can also be a secondary payer if you’re insured through an employer or Medicare.

There are a few documents you’ll need to apply:

  • Proof of household income for the last 30 days
  • Social Security Number(s)
  • If you’re Legal Permanent Residence or student/work visa, have documentation
  • If pregnant, a due date letter

There are two key ways to apply for Medicaid:

  1. With nonprofit assistance: Take Care Utah (TCU) is a nonprofit helping individuals apply for Medicaid, CHIP and Marketplace coverage for free. TCU is statewide and can help people in several languages. Find free help at TakeCareUtah.org, call 2-1-1 or book a virtual enrollment appointment here.
  2. On your own: You can apply for Medicaid online at Medicaid.utah.gov/apply-Medicaid or call 1-866-435-7414.
  • Medical
    • Doctor, hospital and emergency services
    • Prescriptions
    • Laboratory and X-rays
    • Behavioral health services
    • Addiction and recovery treatment services
    • Family planning services
    • Maternity care
    • Preventive and wellness services
    • And more (full list here)
  • Dental
    • Pregnant women, those eligible for Child Health Evaluation and Care (CHEC), and most elderly and members with disabilities have these dental benefits:
    • Exams
    • Cleanings
    • X-rays
    • Fillings
    • Root canals on some teeth
    • Silver Crowns

All other Medicaid members only get limited emergency dental.

  • Vision
    • a yearly eye exam
    • For pregnant women and those who receive CHEC benefits have limited coverage for glasses
    • Contacts are not covered.

Medicaid members have $0 annual premium with minimal co-pays:

Service Co-pay
Pharmacy $4 per prescription, up to $20 per month
Physician visits, outpatient hospital $4, up to $100 per year
Vision $4 for ophthalmologists
Family planning, immunizations, preventive, radiology, lab, outpatient mental health/substance use disorder treatment $0
Inpatient hospital $75 co-pay for each hospital stay
Emergency Room (ER) $0 for emergency use of ER
$8 for non-emergency use of ER

Certain populations do not have co-pays including:

  • American Indians
  • Alaska Natives
  • Pregnant women
  • Members getting hospice
  • Members in the Medicaid Cancer Program
  • Members eligible for EPSDT (also called CHEC)